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Individual

DR. KELLEY MELISSA BASINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4235 INDIAN RIPPLE RD, STE 100, BEAVERCREEK, OH 45440-3247
(937) 427-2020
(937) 429-1144
Mailing address
4235 INDIAN RIPPLE RD, STE 100, BEAVERCREEK, OH 45440-3247
(937) 427-2020
(937) 429-1144

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4808
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2184274
OH
Enumeration date
08/12/2005
Last updated
10/17/2012
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